Bad Body/Sweat Odor - RichVanK or anyone else?

Hi all,
I've had the Fibro diagnosis for about 14 years. Recently, I went to see Dr. Bhakta in Orange, CA. because I wanted to see if I had a methylation problem. She hasn't tested me for that yet but she did do an Igenex Lyme test on me and it is positive. I've also tested positive for Sjogrens disease through blood test through my rheumatologist.

Before I went to Dr. Bhakta I began having many bladder infections and had a bad case of salmonella poisoning all starting in April of this year. I'm still having bladder issues - seems like cystitis. Dr. Bhakta has me on a multi vitamin and probiotics and is testing me for the XMRV virus.

For the last several months, I've been having bad body odor smells. Most of my friends and family can't smell it but I can. It seems to be bad at work and I know others at work smell it. I work in an old building. For example, every so often I smell either a fishy, rotten trash or formaldehyde smell not only in my nose/throat but on my hands and sometimes other parts of my body. And there are times when my urine smells really bad - sometimes sulfur like or fishy. I'm also really sensitive to sulfur smells. The smell problems seem to be worse after I eat. I asked the Dr. if it could be the multi-vitamin I'm taking but she didn't think so. There is carnitine, alpha lipoic acid and n acetyl cysteine in the multi.

I did some research and found that some people have problems metabolizing choline, I think the disorder was called TMA and I'm worried that could be my problem. But there is no cure, evidently. I've been sensitive to smells for a while but this all got worse at the beginning of the year when my bladder problems started. I even smelled ammonia on me for the longest time. Now the smells are worse and different. I also have some blood sugar problems, probably hypoglycemia, though doctors can't find anything wrong. I don't have diabetes.

Does anyone else have this problem? Rich, can you give me your thoughts on this? It's really bothering me since I don't want to be offensive to my coworkers. I shower everyday and wear deodorant although I have to be careful about scented products and most deodorants w/ aluminum. I can't take the smell. I think I'm having some chemical sensitivity issues. I remember reading that some people doing the methylation protocol noticed bad sweat and urine smells which is why I'm asking.

I'm sorry to hear about the problems you are having, but glad to hear that you are seeing Dr. Bhakta. I hope that she will be able to help you.

With regard to the fishy odor, as you noted, this is usually caused by trimethylamine, which is produced by anaerobic bacteria in their fermentation of choline. This happens in normal, healthy people, too, but there is normally an enzyme in the liver that oxidizes trimethylamine to trimethylamine-N-oxide, which is odorless. As you mentioned, there is a genetic disorder in which this enzyme is deficient, and people with this genetic mutation have a fishy smell from birth. In your case, it sounds as though this is not something you have had all your life, so I suspect that you do not have a genetic deficiency in this enzyme. Rather, I suspect that trimethylamine is being overproduced in your body because of bacterial dysbiosis. Usually this happens in the gut, but given the association you have noted with the bladder inflammation, I'm guessing that it's possible for unfriendly bacteria in the urinary tract to produce trimethylamine, also. One of my symptoms books says that a fishy odor can be associataed with bladder inflammation, so that's another piece of evidence that suggests that a bladder infection might be involved.

In the long term, I think the solution will have to be clearing the bladder infection, if present, and correcting the gut dysbiosis, if present.

In the shorter term, you might ask Dr. Bhakta what she thinks about your taking activated charcoal. It has been found to bind trimethylamine in the gut. See the abstract below. It also mentions copper chlorphyllin, but I think that activated charcoal would be easier to get.

Best regards,

Rich

Life Sci. 2004 Apr 16;74(22):2739-47.
Effects of the dietary supplements, activated charcoal and copper chlorophyllin, on urinary excretion of trimethylamine in Japanese trimethylaminuria patients.

Trimethylaminuria (TMAU) is a metabolic disorder characterized by the inability to oxidize and convert dietary-derived trimethylamine (TMA) to trimethylamine N-oxide (TMAO). This disorder has been relatively well-documented in European and North American populations, but no reports have appeared regarding patients in Japan. We identified seven Japanese individuals that showed a low metabolic capacity to convert TMA to its odorless metabolite, TMAO. The metabolic capacity, as defined by the concentration of TMAO excreted in the urine divided by TMA concentration plus TMAO concentration, in these seven individuals ranged from 70 to 90%. In contrast, there were no healthy controls examined with less than 95% of the metabolic capacity to convert TMA to TMAO. The intake of dietary charcoal (total 1.5 g charcoal per day for 10 days) reduced the urinary free TMA concentration and increased the concentration of TMAO to normal values during charcoal administration. Copper chlorophyllin (total 180 mg per day for 3 weeks) was also effective at reducing free urinary TMA concentration and increasing TMAO to those of concentrations present in normal individuals. In the TMAU subjects examined, the effects of copper chlorophyllin appeared to last longer (i.e., several weeks) than those observed for activated charcoal. The results suggest that the daily intake of charcoal and/or copper chlorophyllin may be of significant use in improving the quality of life of individuals suffering from TMAU.

Rich,
Thanks for your comments. I actually picked up some charcoal yesterday and I will look at getting the chlorophyl as well. I'll check w/ Dr. Bhakta first.

I've been treated for gut problems before and since the salmonella and three bladder infections I've taken Cipro twice and Macrodantin twice. I know my gut is probably a mess. But I am taking probiotics. It doesn't seem to be helping though.

It seems as though anything I ingest is coming out through my skin - I can even smell the multi-vitamin after I take it.

I'm 47 and know my hormones are changing so thought maybe it was related to that. But now I think it's due to the infection(s). I also have a thyroid nodule that was recently biopsied and turned out to be fine. The doctor says my thyroid is OK otherwise but I'm not so sure.

Thanks again for your response. I really appreciate your participation on this board.
Take care, Theresa

The Carnitine in those supplements may be what is causing your odor issue...

"A secondary form of trimethylaminuria may result from the side effects of treatment with large doses of the amino acid derivative L-carnitine (levocarnitine). The metabolic deficiency occurs as a result of a failure in the cell to make a specific protein, in this case, the enzyme flavin-containing monooxygenase3. Enzymes are nature's catalysts and act to speed up biochemical activities. Without this enzyme, foods containing carnitine, choline and/or trimethylamine-N-oxide are processed to trimethylamine and no further, causing a strong fishy odor. This secondary form of the disorder is a result of an overload of trimethylamine. In this case, there is not enough of the enzyme to get rid of the excess trimethylamine."